Comparison of Roux-en-Y gastrojejunostomy and Billruth-II with Braun anastomosis for gastric reconstruction following partial gastrectomy

Background and aims: Partial gastrectomy surgeries are conducted frequently due to various reasons but there is no consensus regarding the method of choice for gastrointestinal reconstruction. In this study we aimed to compare billruth II with Braun anastomosis and Roux-en-Y gastrojejunostomy. Materials and methods: This prospective study was conducted on patients presented to surgery clinic at Besat and Taleghani hospital between 2018-2020 who were gastrectomy candidates. Patients undergoing Billruth 2 reconstruction with Braun anastomosis or Roux-en-Y gastrojejunostomy were enrolled in the study. Demographics, operation durative and intraoperative blood loss, early postoperative complications, re-admission within 30 days postoperation, 30-day and 90-day mortality were recorded. at an at least 3-month post-surgery period, patients were followed for late postoperative complications. If necessary, endoscopy was conducted and biopsy was taken. Analysis was performed with SPSS version 22. Results: 84 patients in two 42-patient groups were evaluated. All parameters were the same in two groups except operation duration and intraoperative bleeding (significantly higher in RY group), food residue (significantly higher in RY group) and bile in remnant stomach (significantly higher in B2B group). Conclusion: These two methods of reconstruction are comparable in terms of postoperative complications and mortality rates. Food residue and bile reflux are two determinants which should be kept in mind when choosing the surgery plan by surgeons.